APPLICATION FOR HOUSING

southernministorage@gmail.com

Application

There is a $20 application fee. Please contact our office after filling out this application, 910-277-0743, to pay and have your application evaluated. By filling out this application you are declaring that the statements are true and correct, and hereby authorize verification of the references given as well as background and credit checks.

Applicant Information
First Name: *
Middle Name: *
Last Name: *
Phone: *
Address Street 1: *
Address Street 2:
City: *
Zip Code: *	(5 digits)
State:
Birth Date:
Drivers License:
State License Issued:
Current Employer:
How Long Empoyed:
Gross Monthly Income from Employer:
Other Monthly Income:
Email Address:
Current or Most Recent Landlord Name:
Landlord Phone:
Reason for Moving:
Co-Applicant Information
Co-Applicant First Name:
Co-Applicant Middle Name::
Co-Applicant Last Name::
Co-Applicant Phone:
Co-Applicant Address Street 1:
Co-Applicant Address Street 2:
Co-Applicant City:
Co-Applicant Zip Code:	(5 digits)
Co-Applicant State:
Co-Applicant Birth Date:
Co-Applicant Drivers License:
Co-Applicant State License Issued:
Co-Applicant Current Employer:
Co-Applicant How Long Employed:
Co-Applicant Gross Monthly Income from Employer:
Co-Applicant Other Monthly Income:
Co-Applicant Email Address:
Co-Applicant Current or Most Recent Landlord Name:
Co-Applicant Landlord Phone #:
Contact Information
Daytime Phone:
Evening Phone:
Email:
Other Information
Number of Bedrooms Requested:
Interested In:
Have You Ever Been Evicted?:
Have You Ever Filed Bankruptcy?:
List any other people and their ages that will be living in the home:
Personal Reference Name, Address and Phone Number:
Do You Have Pets? If yes, what are they?:
Enter Additional Comments:	Enter comments here!
	I authorize Southern Mini Storage, Inc to verify my credit and employment history.

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APPLICATION FOR HOUSING